Duodenojejunostomy versus Distal Gastrectomy and Roux-en-Y Gastrojejunostomy in Management of Superior Mesenteric Artery Syndrome: Retrospective Cohort Study.

Document Type : Original Article

Authors

1 Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

2 Upper Git unite, General Surgery Department, Ain Shams University Hospitals, Cairo, Egypt

3 Bariateric Surgery Unit, General Surgery Department, Ain Shams University Hospitals, Cairo, Egypt

Abstract

Introduction: Superior mesenteric artery (SMA) syndrome is a rare gastrointestinal disorder characterized by
compression of the third part of the duodenum between the abdominal aorta and SMA.
Aim of work: To compare outcomes of duodenojejunostomy (Open/laparoscopic) versus distal gastrectomy with
Roux-en-Y gastrojejunostomy (Open/laparoscopic) in managing SMA syndrome, focusing on symptoms relief and
surgical complications.
Patients and methods: A retrospective cohort study with data analysis from 22 SMA syndrome patients admitted
to Ain Shams University Hospital’s Upper GIT Unit from January 2021 to December 2024.
Results: This study compared postoperative outcomes between duodenojejunostomy (Group A) and distal
gastrectomy with Roux-en-Y gastrojejunostomy (Group B). Duodenojejunostomy resulted in shorter surgery
durations and hospital stays. Although reintervention rates were similar, vomiting and readmission rates were
higher in Group A. Group B demonstrated favorable long-term outcomes, with lower complication rates and
reduced readmissions.
Conclusion: Both surgical approaches effectively managed SMA syndrome symptoms. Duodenojejunostomy
offered shorter surgery and hospitalization times, while distal gastrectomy with Roux-en-Y gastrojejunostomy
reduced postoperative vomiting and complications, suggesting potential long-term benefits.

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